Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jamilia Lashawn Broussard, MSNRNFNP-BCWCC

Individual provider Family Nurse Practitioner · NPI 1184122145

Mrs. Jamilia Lashawn Broussard, MSNRNFNP-BCWCC is a Nurse Practitioner in Ardmore, Oklahoma. Qualified in 2017, 9 years ago. Practices with Integrated Wound Specialists of North Carolina, PLLC, a 17-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
9
Licensed in
TX
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

1001 12th Ave NW
Ardmore, OK 73401-5712
Phone: (580) 220-6290
Fax: (580) 220-6215
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP136689 (TX)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 821209 (TX)

Record details

NPI number1184122145
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSNRNFNP-BCWCC
Sole proprietorNo
NPI enumeratedJanuary 24, 2018
Last updated in NPPESAugust 3, 2021
Certification dateAugust 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Integrated Wound Specialists Of North Carolina, Pllc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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